PMID: 8968171Dec 1, 1996Paper

Residual postoperative paralysis. Pancuronium versus mivacurium, does it matter?

Anesthesiology
A F KopmanP S Yee

Abstract

Based on a train-of-four (TOF) ratio greater than 0.70 as the standard of acceptable clinical recovery, undetected postoperative residual paralysis occurs frequently in postanesthesia care units. In most published studies, detailed information regarding anesthetic management is not provided. The authors reexamined the incidence of postoperative weakness after the administration of long- and short-acting neuromuscular blockers because few, if any, such comparative studies are available. Ninety-one adult patients were studied. In group 1 (mivacurium, n = 35), anesthesia was induced with propofol/ fentanyl and maintained with nitrous oxide, desflurane, and opioid supplementation. The response of the adductor pollicis to ulnar nerve stimulation was estimated by palpating the thumb. Mivacurium (0.20 mg/kg) was administered for tracheal intubation, and an infusion was adjusted to maintain the TOF count at 1. When surgery was completed, the infusion was discontinued. When a second twitch could be detected, 7.0 micrograms/kg atropine and then 0.5 mg/kg edrophonium were administered. At 5 and 10 min, the mechanical TOF response was measured. Additional measurements were recorded if possible. Patients were tracheally extubated and discha...Continue Reading

References

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Citations

May 1, 1997·Anesthesiology·D R Bevan, J C Bevan
Nov 20, 1997·Anesthesiology·P R FreundV D Burkhart
Jun 17, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·D R Bevan
Oct 4, 2006·Current Opinion in Anaesthesiology·O Plattner, M Zimpfer
Jul 19, 2008·Anesthesia and Analgesia·Sorin J BrullRonald D Miller
Jan 23, 2016·Expert Opinion on Pharmacotherapy·Friederike Haerter, Matthias Eikermann
Nov 20, 1997·Anesthesiology·A F Kopman
Feb 26, 1998·Anesthesiology·G D'HonneurP Duvaldestin
Dec 26, 2001·Anesthesiology·Hans KirkegaardJames E Caldwell
Jul 17, 1998·Anesthesiology·J Viby-Morgensen
May 26, 1998·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·F Donati
Sep 16, 2009·Current Opinion in Anaesthesiology·Paul H AlfilleMatthias Eikermann
Feb 19, 2009·Anaesthesia·C ClaudiusJ Viby-Mogensen
Sep 20, 1997·Anesthesia and Analgesia·J C Ballantyne, Y Chang
Apr 23, 2009·Current Opinion in Anaesthesiology·Mohamed Naguib, Sorin J Brull

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